The infrastructure support requested includes a sufficient number of (PDAs) and training to ensure that all member practices are able to collect and transmit research data electronically. A PDA trainer will also teach the practices to use the PDA Preventive Services Reminder System, which will facilitate collection of routine practice data and increase the delivery and documentation of preventive services. A network coordinator will work with the current Native American member practices, their tribal councils, and the Indian Health Service to improve our ability to include these clinics in network projects. She/he will also develop a better-organized recruitment and retention process, targeting new practice recruitment to practices serving minority populations and larger practices, which are currently underrepresented. All of the requested funds will go directly to these infrastructure elements since the University has waived its request for indirect costs for this portion of the project. The proposed exploratory/pilot project involves a randomized trial of three interventions for improving the management of diabetic patients. It is designed to test the impact of a best-practice method developed using a research process that we have developed for use in practice-based research networks compared to benchmarking. It will also measure the value of practice enhancement assistants (PEAs) for translating research into practice. Information learned from this pilot study should make it possible for us to design larger studies involving additional networks.
